MEDICARE: KARI J NELSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	MD2009-0632	NM
2	2085R0204X	Vascular & Interventional Radiology Physician	A100055	CA
3	2085R0204X	Vascular & Interventional Radiology Physician	MD2009-0632	NM
4	2085R0202X	Diagnostic Radiology Physician	13867553-1205	UT
5	2085R0202X	Diagnostic Radiology Physician	A100055	CA

General Provider Information

NPI Number	:	1992913974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI J NELSON MD

Provider Business Mailing Address
First Line	:	8020 CONSTITUTION PL NE
Second Line	:	SUITE 202
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7607
Country	:	US
Telephone Number	:	505-998-3096
Fax Number	:	505-998-3100

Provider Business Practice Location Address
First Line	:	8020 CONSTITUTION PL NE
Second Line	:	SUITE 202
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7607
Country	:	US
Telephone Number	:	505-998-3096
Fax Number	:	505-998-3100

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	12/08/2024

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Directions to “ KARI J NELSON MD” Practice Location

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